PloS one
2026-01-01
Jakie jest znaczenie nowej masy w piersi u kobiet w wieku 40 lat lub starszych? Badanie przekrojowe
What is the significance of a new breast mass in women aged 40 or above? A cross-sectional study.
Recenzja AI
Cel badania
Celem badania było ocena znaczenia nowo pojawiającej się masy w piersi u kobiet w wieku 40 lat lub starszych jako kryterium podejrzanego w ocenie BI-RADS.
Metoda
Badanie obejmowało kobiety w wieku 40 lat lub starsze z masą w piersi, które były biopsjowane lub obserwowane przez co najmniej 2 lata, a nowo pojawiające się masy były biopsjowane zgodnie z protokołem instytucjonalnym.
Wyniki
Protokół instytucjonalny zwiększył czułość do 84,1% w porównaniu do 70,1% w standardowym protokole, ale zmniejszył swoistość do 40,3% w porównaniu do 95,4%.
Znaczenie dla praktyki
Wyniki sugerują, że uwzględnienie nowości masy jako kryterium podejrzanego może prowadzić do wcześniejszego wykrycia raka piersi, ale zwiększa ryzyko wyników fałszywie dodatnich, co jest istotne dla praktyki klinicznej w Polsce.
Abstrakt oryginalny
BACKGROUND: Breast lumps are the most common presentation of breast cancer, and when detected in imaging, they are assigned a BI-RADS score dependent on their characteristics. Recency of a mass is not among these features, while in our center, the new occurrence of a solid breast mass in women 40 or above is considered suspicious because common benign masses typically occur before this age. We designed this study to evaluate data from our Arash Breast Diseases Registry to explore the results of this personalized approach. METHODS: Women aged ≥40 with a breast mass in exam, ultrasound, or mammography that had been biopsied or followed-up for at least 2 years were included. In addition to BIRADS 4 and 5 or suspicious clinical exam, new solid masses on breast examination, mammography, or ultrasound in women 40 or above were biopsied. We calculated the sensitivity, specificity, likelihood ratios, and predictive values for our institutional protocol and the guideline-based protocol where the recency of the mass is not an indication for biopsy. RESULTS: Among 4865 women, 609 were eligible. The mean age was 49.06 ± 7.84 years; 135 were malignant, and 474 were benign. Our protocol showed an increase in the sensitivity (84.1% vs. 70.1%) and a decrease in specificity (40.3% vs. 95.4%) when compared to the usual protocol. CONCLUSIONS: While our institutional protocol increased the sensitivity and could lead to early detection, it lowered specificity, suggesting more false positive results. Our main suggestion is to consider "recency of a solid mass" as a criterion for suspiciousness in BI-RADS assignment to breast masses. We propose further studies to achieve a protocol that maximizes both sensitivity and specificity without compromising diagnostic reliability, and to find the cut-off for age when the effect of this factor increases.